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Soewarta Kosen Health Economics and Policy Analysis Unit,

ROLES OF DEVELOPMENT ASSISTANCE IN SUPPORTING HEALTH SYSTEMS POLICY FORMULATION AND REFORM IN INDONESIA*. Soewarta Kosen Health Economics and Policy Analysis Unit, Center for Community Empowerment, Health Policy and Humanities, National Institute of Health Research & Development

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Soewarta Kosen Health Economics and Policy Analysis Unit,

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  1. ROLES OF DEVELOPMENT ASSISTANCE IN SUPPORTING HEALTH SYSTEMS POLICY FORMULATION AND REFORM IN INDONESIA* Soewarta Kosen Health Economics and Policy Analysis Unit, Center for Community Empowerment, Health Policy and Humanities, National Institute of Health Research & Development Ministry of Health Republic of Indonesia *Presented at the 4th Technical Review and Planning Meetingfor the Health Policy and Health Finance Knowledge Hub, Melbourne 10-11 October 2011

  2. THE HEALTH SECTOR IN INDONESIA IS CHANGING • The mix of diseases (double burden)is changing due to the epidemiological and demographic transition: • The private sector has played an important role in meeting the demand for health services • These changes with different pace of area development will continue in the future • Overall health spending (both private and public) is low by international standards, and much of current public sector health spending is devoted to curative care • Decentralization of the health sector and democratic environment, human rights issue (compulsory assignment of health man-power, hospital autonomy, health equity, poverty alleviation) change the climate • Growing number of middle income population and better educated civil society demand better quality of health care (GDP per capita in 2010: US $ 3,300.00)

  3. HEALTH SECTOR REFORMS • Main strategies and health programs Influenced by world environment and agenda of international agencies, among others: • Child survival (Unicef, USAID) • Safe Motherhood/Making pregnancy Safer (WHO, UNICEF, UNFPA, USAID, AusAID) • Fighting ATM (Global Fund, WHO, AusAID) • Malaria control program (USAID, WHO) • Managed Care (USAID) • Social health insurance (GIZ) • Decentralization of health sector (WHO, World Bank, ADB, European Union) • Investment in Health (World Bank) • MDGs, NCD (UN, World Bank, WHO, etc.) • Health Systems Strengthening (WHO, AusAID, World Bank, Global Fund)

  4. How? • By exposing policy makers to international initiatives thru international, regional & national conferences/ workshops/meetings • Organizing in-country policy workshops /seminars (WB organizing several policy workshops for decision makers on Investment in Health, Health Transition & NCD, Decentralization, Human Resources for Health; WHO-TFI: on tobacco tax) • Thru development assistance (Grants, Loans) • USAID: managed care project, health sector financing project, Hospital Autonomy, Family Planning, HIV/AIDS • WB and ADB: Decentralization of health sector • WB, GIZ: Health Management Information System • JICA: MCH Handbook • AusAID: NHA, Making Pregnancy Safer • Global Fund, AusAID: Health Systems Strengthening

  5. DIRECT DEVELOPMENT ASSISTANCE FOR POLICY • USAID supported the the formation of Health Economics and Policy Analysis Unit of the Bureau of Planning, MoH (1988) and policy research activities • GIZ supported development of the Center for Health Policy & Development, MoH and development of Social Health Insurance (2004) • The MoH maintains independency in policy formulation

  6. CURRENT HEALTH SYSTEMS POLICY FORMULATION • Growing number of national & local health experts in various fields (educated in country and overseas) • Better capacity in implementing policy research, policy analysis and engaging in politics of health • Increased national and local health budgets • Increased roles of national and local parliament in health planning and budgetting • Increased transparancy and roles of civil society

  7. What are still needed? • Operations research/health systems research and policy research • Pilot projects • Technical assistance with specific tasks • Equal cooperation in conducting research and training • Advocacy Seminars/Workshops on specific topics • Capacity development in specific area: equity analysis

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